Arizonans are well aware of the impact that COVID-19 is having around the world. However, less attention has been placed on the unique position Arizona is in, both in terms of potential risk as well as the opportunity we have to slow the spread of this virus among our communities.
As of March 24, there are 326 confirmed cases statewide, nearly 100 more than a day earlier. Five deaths have been recorded, and no confirmed recoveries. There are likely far more actual cases in the community, which have not been confirmed due to either a lack of testing, or cases with mild or no symptoms not active in the health care system.
I am an epidemiologist. We study diseases and their risk factors within populations. Though our knowledge is still evolving as more studies are conducted, there are several risk factors consistently associated with severe disease and death from COVID-19, including advanced age, being male or having the presence of preexisting medical conditions such as cardiovascular disease or chronic respiratory infections. These findings are particularly relevant because Arizona’s population tends to be older than the national average as well as the U.S. states that have been most impacted by this pandemic (17.5% are over 65 years of age compared with 15.6% nationally according to recent census estimates). In some communities, this proportion is even higher (e.g. Sun City, whose median age is 73 years with 76% aged 65-plus).
Though the serious disease can occur in younger adults as well, a higher proportion of older inhabitants adds to the potential burden that will be placed on the health care system should an outbreak occur. Look no further than Italy, whose older population has been severely affected by this pandemic.
“Flattening the [epidemic] curve” has, wisely, been included in many media reports in recent days. Perhaps the most important reason for decreasing the number of new cases of COVID-19 per day is to avoid overwhelming the health care system. Early, aggressive preventive measures give health care professionals a better chance of providing the care needed for the sickest patients.
Cause for concern
We do not have an unlimited number of hospital beds and health care providers. Arizona has approximately 1.8 staffed hospital beds per 1,000 population, compared with 1.3/1,000 in Washington, 1.9/1,000 in California, and 2.9/1,000 in New York. Though Arizona is not the worst offender in this category, taken together with the demographic profile of the state and its individual communities, the large homeless population, and a significant population without ready access to high-level hospital care, this should be a cause for concern.
Every Arizonan must take seriously their personal responsibility to heed the advice of public health professionals to follow social distancing (i.e. stay at home), washing hands frequently, avoiding crowds, and staying up to date on immunizations because these are the tools that are within our control. If we can decrease the overall burden of serious illness within our communities. It is imperative that we minimize the cumulative stress placed on our hospitals.
Arizona is at a crucial juncture in slowing the spread of the virus in our state. Compared with Washington, New York and California, we have not begun to experience the exponential growth portion of the epidemic curve. The sooner aggressive measures are implemented and followed, the better success we will have in “flattening the curve,” allowing our first responders and health care providers to do their job, and protecting the most vulnerable among us.
We owe it to our fellow Arizonans to think as a community to ensure a healthy future for everyone.
Kyle Freese, Ph.D., is an epidemiologist at Phoenix-based STChealth.